Alcohol Misuse Prevalence and Associations with Post-Operative Complications in US Surgical Patients: A Review

We conducted a standardized review of research on the prevalence of alcohol use or misuse (including alcohol use disorders), and the association of alcohol use or misuse with post-operative surgical complications among US patients. Twenty seven studies that included a preoperative measure of alcohol use or misuse and included at least 50 US surgical patients were identified using a standardized search strategy (1950( -April 2007)). Twenty-two of the studies reported prevalence of alcohol use or misuse, which was highest in major otolaryngology surgeries (mostly for cancer and injuries: 22-88.5%) and thoracic surgery (lung transplant and cancer resections: 29-33%) and ranged from 8-28% in the remaining studies. Nineteen studies examined the association between pre-operative alcohol consumption and post-operative complications suggesting positive associations between alcohol use or misuse and risk for post-operative delirium, pneumonia, cognitive decline, overall complications, and death. Most identified studies had methodological limitations, especially the widespread use of drinking assessment methods that cannot distinguish alcohol use from misuse.